Heart Failure and Multimorbidity in Australian General Practice
Heart failure (HF) is a serious condition that mostly affects older people. The prevalence of many chronic conditions increases with age yet current guidelines focus on management of HF alone. The aim of this study was to describe the burden of multimorbidity in patients with HF being managed in general practice in Australia.
Data from the Bettering the Evaluation And Care of Health (BEACH) program were used to determine prevalence of HF, the number of co-existing long term conditions and the most common disease combinations in patients with HF. The study was undertaken over fifteen five week recording periods between November 2012 and March 2016.
The dataset included a total of 25,790 GP encounters with patients aged 45 years or older, collected by 1,445 GPs. HF had been diagnosed in 1,119 of these patients, a prevalence of 4.34% (95% CI 3.99–4.68) among patients at GP encounters and 2.08% (95% CI 1.87–2.29) of the general population. HF rarely occurred in isolation, with 99.1% of patients having at least one other chronic disease and 53.4% having six or more. The most common pair of comorbidities among active HF patients was hypertension and osteoarthritis (43.4%).
Overall, one in every 20-25 GP encounters with patients aged 45 years or older in Australia is with a patient with HF. Multimorbidity is the norm and guidelines for general practice must take this into account.